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diagnosis

Adrian looked around the waiting room, noting that he was
easily the youngest person there. Most of the people sitting in the room were
easily a decade older than him, probably more, and that all of them were women.
This made him embarrassed. He knew that most people seeing a rheumatologist
were women and probably older, but seeing it in person was different.

Feeling uneasy while waiting

Adrian
tried to ignore his embarrassment by looking at the decorations on the wall,
which was all still life photographs. He had to suppress a snort, of course
that’s what was on the walls. Just like every doctors office, there has to be
boring, framed photos of nothing interesting.

“Adrian
Thompson,” the nurse called.

Standing up
slowly, Adrian followed the nurse to the exam room in the back. Even as he
followed her, he couldn’t keep up and had to walk significantly slower than her
because the pain in his joints was so bad. He immediately sat down in the lone
chair in the corner when he reached the room, ignoring the exam table.

“What
brings you in today?” the nurse asked.

“I’ve
been having pain and swelling in my joints, muscle pain, fatigue, and stiffness
when I wake up in the morning or if I move after I’ve stayed in the same
position for too long” Adrian replied.

She wrote
everything down, looked at him quizzically, and said the doctor would see him
soon. Adrian looked around the room after she left. He noted several arthritis
posters, a osteoporosis poster, and some three dimensional models of joints on
the counter.

The doctor

30 minutes
later, the rheumatologist, Dr. Erikson, entered the room. He read the notes
that the nurse had made and asked what brought him in. Adrian repeated exactly
the same thing he had said to the nurse.

“Hop
onto the exam table,” he said.

Adrian
flinched several times when Dr. Erikson pressed on points that hurt, then
ordered some blood tests and offered to prescribe him painkillers for the
intervening days until he saw him again.

“No,
thank you,” Adrian said, “I am an addict in recovery, I have 60 days
clean and sober today, and I don’t want to risk going back into active
addiction.”

“Good
for you getting sober,” Dr. Erikson said. And with that, he left the room,
telling Adrian to make another appointment in 30 days.

Second appointment

The
following 30 days were agonizingly painful and long. Adrian desperately wanted
to know what was wrong, because something was obviously wrong. The constant
pain was something he didn’t think he’d ever get used to, almost worse than the
pain was the fatigue that was making it hard to be a functional human being.
Adrian could barely remember what it felt like to wake up feeling rested.

Returning
to the doctor’s office, Adrian waited an hour just in the waiting room just to
wait another hour in the exam room. When Dr. Erikson finally, finally, showed
up, Adrian became hopeful that he might finally have an answer. He was
disappointed.

“Here
is the business card of a good psychiatrist in the area. I’d recommend talking
to her and getting on the proper medication” the doctor told him.

Adrian was
so upset he couldn’t speak. Even a doctor, the best rheumatologist in a 50 mile
radius, thought he was making up the pain and various symptoms he was
experiencing. Adrian numbly walked out of the office and got into his car. When
he closed the car door, he finally broke down. He wasn’t crazy, was he? He
didn’t think so. But either way, he pulled out the psychiatrist’s card and made
an appointment.

Continuing the search for awnsers

Over the
next year, Adrian searched for an answer. He saw the psychiatrist, who referred
him to a therapist and a different rheumatologist, that rheumatologist referred
him to a different psychiatrist, who told him to see another rheumatologist. He
didn’t have anyone actually believe he was actually in pain until he finally
gave up on specialists and saw his general practitioner.

Adrian
told his general practitioner his symptoms, telling him about all the struggles
to find an answer, and he watched the doctor’s eyes light up. Adrian knew then
that he finally found a doctor who completely believed him, and he was
ecstatic.

“Here’s
an order for more blood tests and an order for getting your hands and feet
x-rayed,” Dr. Johnson said, handing Adrian the stated orders, “Come
back in two weeks and we’ll review the results.”

U.S. Army Spc. Juan Hernandez, Jr., McDonald Army Medical Center U.S. Army Medical Activity medical laboratory technician, draws a blood sample from a patient at Joint Base Langley-Eustis, Va., June 26, 2017. The JBLE lab technicians perform over a million tests annually and study the hematology, coagulation, chemistry and microbiology of the samples. (U.S. Air Force photo/Staff Sgt. Teresa J. Cleveland)

Adrian
immediately went to get his blood drawn, and two weeks later he was back at the
office, eagerly awaiting the results.

The results

“Adrian
Thompson,” the nurse called. Adrian got up and followed the nurse into the
exam room, and 20 minutes later Dr. Johnson came in.

He spent
five minutes looking at the results from Adrian’s tests, and then looked at
Adrian.

“I know
what’s wrong,” Dr. Johnson told Adrian.

“What?”
Adrian asked eager to finally have an answer.

“I
have two diagnoses for you. The first is about the joint pain. You have no
markers for it, but you have what’s called seronegative rheumatoid arthritis,
based on the high amount of inflammation and the damage to the joints in your
hands and feet. The second is related to the muscle pain, and there’s no
specific test for this, but I believe you also have fibromyalgia.”

Those were
exactly what Adrian thought he had from his research, but having confirmation
was both a relief and a weight on his shoulders.

“So
where do we go from here?” asked Adrian.

“I
will give you a copy of the results and write a diagnosis on a prescription
pad, and I’ll give you a card for a rheumatologist. He will know better on what
medications to put you on, but I’ll give you a couple of things to treat the
conditions while you wait to see the rheumatologist.”

Finally getting a diagnosis

Adrian
went home in a daze. As soon as he got home he called and made an appointment
with the recommended rheumatologist. With that done, Adrian got back into his
car and began the hour and a half drive to the beach, the place that always
seemed to calm him. Since it was still winter and he was in Washington, Adrian
made sure to take a heavy coat with him. He tried not to think much on the
drive, and to appreciate the beauty of the forest around him.

When he
reached the beach, he put on the coat and began to walk along to beach right on
the edge where the forest ended and the beach began. The beauty of the place,
with the rock cliffs in the middle of the ocean that somehow had trees on top
the constant green of the forest, and the drift wood that had washed up on
shore. This place always brought Adrian a sense of calm. Adrian got to be alone
with his thoughts since it was nearly deserted because it was no longer tourist
season.

As Adrian walked, he thought about how much his life would
change because of the two diagnoses he was just given. He didn’t know if he
would be able to continue to work at his goals, if he would be able to work as
a nurse like he was studying for. He didn’t know if he could continue to live
in this beautiful area, because the weather always hurt his joints. But most of
all, Adrian thought about how scared he was about the future. He knew what
advanced rheumatoid arthritis could do to joints. He had seen the pictures online. Adrian even
let out a couple tears as rain began to fall, counting on the rain to hide his
tears from anyone who might look at him.

Adrian
knew his life was about to change, and as he got back into his car to begin his
drive home, he tried to just be grateful to finally have an answer after over a
year of searching and allow the future to turn out however it’s meant to.

Chris Thoman is a 23 years old, college student, and lives with several chronic illnesses. He loves meeting and talking to new people, especially those who struggle with similar things as him. Follow him on Instagram

Adrenal disease can be life-threatening and is rarely tested for. This post was written to explain how to be properly tested for adrenal disease. This is not to be used to diagnose or treat condition. Contact your doctor before starting or stopping any medication or treatment.

There are many forms of adrenal disease-

Adrenal Insufficiency- Disease of the adrenal glands, resulting in the lack of cortisol production. Can also result in lack of DHEA, aldosterone and disrupt the balance of endocrine hormones, electrolyte balances and blood sugar levels.

Secondary Adrenal Insuffiency- When the pituitary gland does
not produce the hormone ATCH (Adrenocorticotropic hormone)
resulting in the lack of cortisol production in the adrenal glands.

Tertiary Adrenal Insuffiency- When the hypothalamus fails to
release CRH (corticotropin-releasing hormone) which stimulates the
production of ACTH by the pituitary gland.

Congenital adrenal hyperplasia (CAH)- Genetic disorder present from birth that impairs the adrenal glands. CAH patients lack the enzymes the adrenal glands use to produce hormones that help regulate metabolism, the immune system, blood pressure and other essential functions.

Cushings Disease- A rare condition that is the result of too much cortisol production in the body. One source of Cushings is when the adrenal glands have a tumor; making too much cortisol. Another cause of Cushing’s syndrome is when the body makes too much of the hormone ACTH; which causes the adrenal glands to make cortisol.

Possible Symptoms of Adrenal Insufficiency-

(Note- This disease is sometimes referred to as “Syndrome X” because it presents different in everyone. The following symptoms are possible ailments that may be present in adrenal disease but are not all inclusive.)

If you are craving sea salt or salty foods, PLEASE get tested. That is one of the most prominent signs of adrenal disease.

The primary diagnostic tests that endocrinologists use to diagnose adrenal disease:

ACTH stimulation test- Measures how well the adrenal glands respond to the release of the adrenocorticotropic hormone (ACTH). When this test is done, blood is drawn prior to injection of ACTH, then at 30 minute intervals for a few hours to test your adrenal response to the ACTH. If your cortisol levels do not rise properly, you are then diagnosed with adrenal insufficiency.

Dexamethasone Suppression Test- Tests adrenal gland function by measuring how cortisol levels change in response to the steroid dexamethasone. This test has historically been used to diagnose depression as well.

8am Cortisol Blood Draw- Your body’s natural cortisol levels should be the highest in the morning, according to your body’s circadian rhythm. If your AM levels are low, it indicates an adrenal issue.

(Saliva and urine tests are also performed, but are not as widely accepted for diagnostic criteria)

Alternative Test- An insulin tolerance test (ITT) is a medical diagnostic procedure during which insulin is injected into a patient’s vein, after which blood glucose is measured at regular intervals. This procedure is performed to assess pituitary function and adrenal function.

Important Warnings-

Do not get on any steroids before you have had an ACTH stimulation test. You will forever battle for the right diagnosis with an endocrinologist if you do. Steroids can cause adrenal suppression and if you do not get tested BEFORE your steroid use they will always assume you have secondary adrenal insufficiency, even if that was not the reason you developed adrenal failure.

Do yourself a favor and get tested and discover your body’s natural adrenal function.

Steroids are life saving medications for those with adrenal insufficiency, but they do come with side effects. (Such as- Weight gain, stretch marks, cataracts, glaucoma, easy bruising, acne, increased appetite, increased growth of body hair)

They are not medicines that you want to start on a whim.

Steroids CAN cause adrenal suppression. DO NOT get on them unless your doctor is SURE you need them.

(Acute uses of steroids are common for infections and asthma, this is not what I am talking about. Long term or repeated use DOES come with risks. Please be advised and ALWAYS consult your doctor regarding your medication use)

An adrenal crisis will lead to death if left untreated. If you suspect you are having adrenal issues, please request the following-

This post is not intended to diagnose or treat any medical condition. Consult your health care provider before starting or stopping any medical treatment. I am NOT a doctor, nor do I claim to be. I am simply an adrenal insufficient woman who has done much research to understand adrenal disease and seeks to help others understand as well.

Multiple Sclerosis is an unpredictable medical condition in which the brain loses control over different parts of the body. Besides the brain, this disease also affects the spinal cord and disrupts the flow of information between the brain and other body parts. Effects of this disease range from mild disruption of communication to total loss of communication between the brain and different body parts. Even in this era of science and technology, this disease is somewhat mysterious. Some physicians believe that Multiple Sclerosis is an autoimmune disease, as the human body has the ability to recover the communication system between the brain and other body parts. Over the past few years, several studies have been launched to investigate the symptoms, causes and treatments of this disease. We have collected some of the best articles on this disease that can help you to understand this disease in a much better way.

1. Multiple Sclerosis

Via: eMedicine Health
This article is very good for those people who don’t know anything about this illness. This piece includes an overview, causes, symptoms, diagnosis, treatment, prognosis, prevention, and medication.

2. NINDS Multiple Sclerosis Information Page

The official website of national institute of neurological disorders and stroke has detailed information of a large number of diseases. In this information page you will find basic things that you must know about multiple sclerosis.

3. What Is MS?

The National Multiple Sclerosis Society is not only striving to increase awareness about multiple sclerosis, but also helping patients all over the world to treat this disease. This is a short article for those who want to know about MS within few minutes.

6. Suicide Rate Almost Double in Patients With Multiple Sclerosis

Some diseases lead people to do things such as committing suicide. Multiple sclerosis has also led some people to suicide, this is a very interesting piece of writing, in which the author addressed this issue underlining the seriousness of MS.

7. Newly Approved Multiple Sclerosis Drug Given To First U.S. Patients Today In Cullman

8. About Pediatric Multiple Sclerosis

Children can also get multiple sclerosis. This emotional article is about the story of children who are fighting MS. This article also explains why it is difficult to diagnose and predict this illness.